22005 S 96th Street | Hickman, NE | 68372
(402) 792-2004
Holland Church
Worship Services Sundays at 9:30 AM
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VBS 2022
VBS is June 13-17th!
Learn More & Sign Up!
Holland Church
VBS is June 13-17th!
Learn More
VBS is June 7th-11th!
VBS Registration
June 13-17, 2022
9:00 AM – 12:00 PM
Ages: 2 Years Old – Entering 8th Grade
Please fill out one form for each child you’re registering.
Step
1
of
3
- Child's Information
33%
Child's Name
*
First
Last
Date of Birth
*
MM
DD
YYYY
Age
*
Gender
Male
Female
Grade child will enter this fall
*
Not in School Yet
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Allergies
Anything else we should know about your child?
Parent/Guardian
*
First
Last
Phone Number (Text)
*
Email Address
*
Additional Parent/Guardian
First
Last
Phone Number (Text)
Email Address
Emergency Contact
Emergency Contact (other than parent)
Phone Number
Person(s) allowed to pick up child other than parent(s)
Home Church
Sibling(s) Attending
List any siblings of this child that will be attending VBS. Please also submit registration forms for each additional child.
May we take pictures of your child to use on Holland's Facebook page & website?
Yes
No
May we take pictures of your child to use in slide presentations in our church?
Yes
No
Email
This field is for validation purposes and should be left unchanged.
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